Abstract:
OBJECTIVE:To evaluate the nursing time required for difficult-to-wean patients in a dedicated weaning center (WC) and to examine the correlation of the nursing time with nursing workload (NW) scores and with clinical severity and dependency. SETTING:Four-bed WC of a pulmonary rehabilitation department. INTERVENTION:None. DESIGN AND MEASUREMENT:Prospective, observational study of 46 consecutive patients admitted to a long-term WC. Time required by items of the Time Oriented Score System (TOSS) and other tasks specific to respiratory intermediate intensive care units were evaluated for all the activities performed on each patient in the first 2 days after admission. Patient dependency and level of nursing care at admission were measured using the Dependence Nursing Scale (DNS) and the Intermediate Therapeutic Intervention Score System (TISS-int). The Acute Physiology and Chronic Health Evaluation (APACHE) II score was also recorded at admission. RESULTS:On the first day each patient needed 45 +/- 15% (63 +/- 23%, 45 +/- 22%, and 29 +/- 14% for the three nursing shifts) of allocated single nursing time. On the TOSS on the first day patients required a daily mean 28 +/- 10% of total available nursing time; on the second day the results did not change. Time of care in the first 24 h was only weakly related to DNS, APACHE II score, and TISS-int; only DNS was able (although weakly; r = 0.45) to predict minutes of nursing care. CONCLUSIONS:In difficult-to-wean patients from mechanical ventilation the nursing time in the first 2 days after admission is high. The use of TOSS may underestimate NW by about 38%. Although only DNS showed the ability to predict minutes of care, the weak relationship limits its value in clinical practice.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Vitacca M,Clini E,Porta R,Ambrosino Ndoi
10.1007/s001340051249keywords:
subject
Has Abstractpub_date
2000-06-01 00:00:00pages
796-9issue
6eissn
0342-4642issn
1432-1238journal_volume
26pub_type
杂志文章abstract::This report identifies some of the risk factors underlying the acquisition of hospital infections in patients admitted to Intensive Care Units (ICUs). Infection rates vary in different institutes and in different types of ICUs. Patients are particularly prone to septicaemia and respiratory infections and the underlyin...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01709700
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between the clinically evaluated depth of midazolam-induced sedation and the cardiac beat-to-beat variability (RR variability) in ICU patients in the intensive care unit (ICU). DESIGN:Prospective study. SETTING:ICU of a university hospital. PATIENTS:20 consecutive patients stu...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709555
更新日期:1996-12-01 00:00:00
abstract:PURPOSE:Relatives of intensive care unit (ICU) patients suffer emotional distress that impairs their ability to acquire the information they need from the staff. We sought to evaluate whether providing relatives with a list of important questions was associated with better comprehension on day 5. METHODS:Randomized, p...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-018-5423-2
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of early transcranial Doppler ultrasound (TCD) goal-directed therapy after severe traumatic brain injury initiated before invasive cerebral monitoring is available. DESIGN:Prospective, observational clinical study. SETTING:Surgical intensive care unit, university hospital. PATIEN...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0558-6
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To assess noise exposure during noninvasive ventilation (NIV) with different types of interface (helmet, nasal, and facial masks). SUBJECTS AND METHODS:Ten "naive" healthy volunteers underwent NIV at pressure support levels of 10 and 15 cmH2O with: (a) helmet, (b) helmet equipped with HME filters at the junc...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-004-2347-9
更新日期:2004-09-01 00:00:00
abstract::A case of brainstem encephalitis complicated by torsade de pointes is described. The possible occurrence of ventricular arrhythmias may contribute to the mortality in this condition. We recommend the admission of patients with brainstem encephalitis to an intensive care unit, for a period of electrocardiographic monit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263564
更新日期:1987-01-01 00:00:00
abstract:PURPOSE:Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. ME...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1735-6
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To investigate whether the addition of intrapulmonary percussive ventilation to the usual chest physiotherapy improves gas exchange and lung mechanics in tracheostomized patients. DESIGN AND SETTING:Randomized multicenter trial in two weaning centers in northern Italy. PATIENTS AND PARTICIPANTS:46 tracheost...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00134-006-0427-8
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVES:To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity. DESIGN:Prospective, observational study. SETTING:Paediatric intensive care unit (PICU). PATIENTS:Ninety-four...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0509-7
更新日期:2007-03-01 00:00:00
abstract:PURPOSE:The aim of our study was to analyze changes in the consumption of MRSA-active antibiotics and in the burden of methicillin-resistant S. aureus (MRSA) over a period of 9 years in a network of German intensive care units (ICU). METHODS:Data from 55 ICUs in Germany were analyzed from 2001 through 2009. The term "...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2335-9
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:We compared two imipenem regimens for prevention of septic complications in patients with severe acute necrotizing pancreatitis (ANP). DESIGN AND SETTING:Prospective, randomized open clinical trial involving intensive care units of 14 Spanish Hospitals. PARTICIPANTS:92 patients with ANP. INTERVENTIONS:Imip...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/s00134-003-1956-z
更新日期:2003-11-01 00:00:00
abstract::Meta-analyses and several large cohort studies have demonstrated that antiseptic mouthwashes are associated with mortality in hospitalized patients. A clear pathogenic mechanism is lacking, leading to controversy and a reluctance to abandon or limit the use of antiseptic mouthwashes. Here, we generate the hypothesis t...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-020-06276-z
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:The association of acute-phase reaction and outcome of patients with acute vascular diseases is controversial. The prognostic value of admission C-reactive protein (CRP) in patients with acute aortic aneurysm or dissection has not yet been investigated. DESIGN AND SETTING:Cohort study including 255 consecuti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1299-1
更新日期:2002-06-01 00:00:00
abstract:INTRODUCTION:The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper was impressive. However, insight into the elements of professionalism as perceived relevant for intensivists from the fellows' view, and how these are taught and learned, is limited. OBJECTIVES AND METHODS:A nationwide study ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1644-8
更新日期:2010-02-01 00:00:00
abstract::Clearly the main determinant of outcome in severe acute pancreatitis is the extent of pancreatic necrosis and the subsequent risk for the development of infected necrosis. A thorough assessment using appropriate scoring systems and the early use of dynamic contrast-enhanced CT will highlight those patients likely to b...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340050808
更新日期:1999-02-01 00:00:00
abstract:PURPOSE:To provide recommendations and standard operating procedures for intensive care units and hospital preparedness for an influenza pandemic. METHODS:Based on a literature review and expert opinion, a Delphi process was used to define the essential topics. RESULTS:Key recommendations include: Hospitals should in...
journal_title:Intensive care medicine
pub_type: 指南,杂志文章,评审
doi:10.1007/s00134-010-1759-y
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To explore translation, conversion and definition ambiguities, when using severity scoring systems in patients admitted to intensive care units (ICUs). DESIGN:A prospective study of the prognosis of acute renal failure in ICUs. SETTING:The study was conducted in 20 French ICUs. PATIENTS:360 patients presen...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01705416
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:To determine the incidence, risk factors, and outcome of barotrauma in a cohort of mechanically ventilated patients where limited tidal volumes and airway pressures were used. DESIGN AND SETTING:Prospective cohort of 361 intensive care units from 20 countries. PATIENTS AND PARTICIPANTS:A total of 5183 patie...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-004-2187-7
更新日期:2004-04-01 00:00:00
abstract::Fifteen polytrauma patients with asymmetric pulmonary contusion were treated with differential lung ventilation (DLV) for a mean of 106 hours (range 24-298, median 83). The differential time constant (Tc), compliance (Ct), inspiratory and expiratory airway resistance (Rawinsp, Rawexp) and peak-airway pressure (Pawpeak...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255602
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To investigate whether the respiratory variation in inferior vena cava diameter (DeltaD(IVC)) could be related to fluid responsiveness in mechanically ventilated patients. DESIGN:Prospective clinical study. SETTING:Medical ICU of a non-university hospital. PATIENTS:Mechanically ventilated patients with sep...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2233-5
更新日期:2004-09-01 00:00:00
abstract:PURPOSE:Meconium aspiration syndrome (MAS) is a life-threatening neonatal lung injury, whose pathophysiology has been mainly studied in animal models. In such models, pancreatic secretory phospholipase A2 (sPLA2-IB) and proinflammatory cytokines present in meconium challenge the lungs, catabolising surfactant and harmi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2243-z
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To assess the impact of hemodynamic variables on the outcome of critically ill patients in septic shock and to identify the optimal threshold values related to outcome with special reference to continuously monitored mean arterial pressure (MAP) and mixed venous oxygen saturation (SvO2). DESIGN AND SETTING:R...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2688-z
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN:Retrospective clinical investigation. PATIENTS AND METHODS:We reviewed the charts of 20 consecutive patients hospitalized in our Int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050959
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:To describe hyperglycaemia as a possible marker of morbidity and mortality in critically ill medical and surgical patients admitted to a multidisciplinary ICU. DESIGN:Prospective cohort study. SETTING:A 13-bed non-cardiac multidisciplinary ICU in a university hospital. PATIENTS AND PARTICIPANTS:Adult patie...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2325-2
更新日期:2004-08-01 00:00:00
abstract:PURPOSE:To assess the impact of lung ultrasound (LU) on clinical decision making in mechanically ventilated critically ill patients. METHODS:One hundred and eighty-nine patients took part in this prospective study. The patients were enrolled in the study when LU was requested by the primary physician for (1) unexplain...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-3133-3
更新日期:2014-01-01 00:00:00
abstract:PURPOSE:To systematically review clinical and preclinical data on hydroxyethyl starch (HES) tissue storage. METHODS:MEDLINE (PubMed) was searched and abstracts were screened using defined criteria to identify articles containing original data on HES tissue accumulation. RESULTS:Forty-eight studies were included: 37 h...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-013-3156-9
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To determine the magnitude and time course of adrenergic effects on metabolism in volunteers and possible implications for the use of sympathomimetics in the critically ill. DESIGN:Descriptive laboratory investigation. SUBJECTS:7 volunteers. INTERVENTION:Primed continuous infusions of stable isotope tracer...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01707665
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To assess the role of antipseudomonal agents on Pseudomonas aeruginosa colonization and acquisition of resistance. DESIGN:Prospective cohort study. SETTING:Two medical intensive care units. PATIENTS AND PARTICIPANTS:346 patients admitted for >or= 48 h. INTERVENTION:Analysis of data from an 8-month study c...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1326-y
更新日期:2009-03-01 00:00:00
abstract:PURPOSE:Chronic pulmonary hypertension (PH) therapy is poorly investigated in intensive care. Our aim was to evaluate haemodynamic and neuroendocrine effects of the dual endothelin-1 (ET-1) blocker tezosentan in monocrotaline (MCT)-induced PH. METHODS:Male Wistar rats (180-200 g, n = 194) randomly received 60 mg kg(-1...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2484-5
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To examine the benefits and risks of vasopressin or its analog terlipressin for patients with vasodilatory shock. DATA SOURCE:We searched the CENTRAL, MEDLINE, EMBASE, and LILACS databases (up to March 2011) as well as reference lists of articles and proceedings of major meetings; we also contacted trial aut...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-011-2407-x
更新日期:2012-01-01 00:00:00